Research on hospital management issues in the DRG payment reform based on social network analysis
10.3760/cma.j.cn111325-20220713-00631
- VernacularTitle:基于社会网络分析的DRG支付方式改革中医院管理问题的研究
- Author:
Jiajun SHU
1
;
Zhijun WANG
;
Yifeng ZHU
;
Lipei WANG
;
Guanwu XU
Author Information
1. 上海市第一人民医院医保资金管理办公室，上海 200080
- Keywords:
Diagnosis-related groups;
Hospital administration;
Social network analysis;
TOPSIS;
Entropy weight method
- From:
Chinese Journal of Hospital Administration
2022;38(10):717-723
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To clarify the immediate administration issues faced by hospitals in China in their implementing the diagnosis-related groups(DRG) payment as a reference for the reform.Methods:By using " DRG" , " hospital" , and " administration" as search terms, the authors systematically retrieved literature data from CNKI, Wanfang Data, PubMed, Embase and Web of Science from the establishment of the database to April 30, 2022. Based on such data, administration issues pertaining to the reform process were extracted and built into a co-word matrix. The social network analysis was used to measure the network density and network centrality of these administration issues. The entropy weight-technique for order preference by similarity to ideal solution(TOPSIS) method was used to comprehensively evaluate the indicator results of network centrality indicators.Results:Of the 32 literatures included, 25 issues in hospital administration during the reform of DRG payment method were extracted. As shown in the social network analysis, the network density was 0.717, while the top issues ranking by degree centrality, betweenness centrality and closeness centrality, were inappropriate main diagnosis selection(68, 8.842, 25), imperfect DRG grouping device setting(54, 8.361, 26), imprecise recording of other disease diagnosis and surgical operations(60, 6.885, 26), and poor professional knowledge of medical record managers(54, 6.991, 25). The top four issues as shown in the entropy weight-TOPSIS analysis were inappropriate main diagnosis selection(1.000), imperfect DRG grouping device setting(0.871), imprecise recording of other disease diagnosis and surgical operations(0.803), and poor professional knowledge of medical record managers(0.787).Conclusions:Fill-out errors of medical record homepage, imperfect formulation of DRG grouping plans and poor professional knowledge of medical record manage team, rank the tope administration issues of high priority in implementing the reform of DRG payment methods. It is imperative to strengthen quality control of the medical record homepages, to scientifically formulate the DRG grouping plans, and to improve the construction of medical records professional team, in an effort to the further smooth and orderly implementation of the reform.
